Hormonal Replacement Therapy in Surgically Induced Menopause: A Prospective Cross Section Study from a Tertiary Care Institution from A Sub-himalayan State

Jatinder Kumar Mokta, Kiran Kumar Mokta, Arjun Tandon, Renuka Pathania, Aniketa Sharma, Monica Raj, Akshit Negi, Arnav Mokta, - Ramesh


Background: Early surgical menopause increases risk of cardiovascular disease, osteoporosis, fracture, cognitive impairment and sexual dysfunction than women with late menopause. Estrogen therapy (ET) remains the most effective therapy for vasomotor symptoms related to surgically induced menopause. Meterials and Methods: It was a prospective cross-section study. Result: Amongst 255 symptomatic women, 163 (63.92%) women had severe vasomotor symptoms and 54 (33.12% of 163 women) of them had very incapacitating symptoms with marked reduction in their quality of life. 59 (23.13%) women had moderate symptoms with mild disturbances in their sleep while 33 (12.94%) women had only mild symptoms. Conclusion: It is agreed that women who undergo bilateral oophorectomy before the onset of natural menopause should be considered for estrogen therapy for the management of vasomotor symptoms until the average age of natural menopause.


Estrogen Therapy, Vasomotor Symptoms, Surgically Induced Oophorectomy

Full Text:



Maclennan AH, Broadbent JL, Lester S, Moore V. Oral oestrogen and combined oestrogen/progestron therapy versus placebo for the flushes. Cochrane Database Syst Rev 2004;Oct 18;2004(4):CD002978.

Rocca WA, Shuster LT, Grossardt BR, Maraganore DM, Gostout BS, Geda YE, “et al”. Longterm effects of bilateral oophorectomy on brain aging: Unanswered question from the Mayo Clinic Cohort Study of Oophorectomy and Aging. Women’s Health 2009;5:39-48.

Grady D, Sawaya GF. Discontinuation of postmenopausal hormone therapy. Am J Med 2005;118 Suppl 12B:163-5.

Santoro N, Allshouse A, Neal-Perry G, Pal L.A, Lobo R, Naftolin F, “et al”. Longitudinal changes in menopausal symptoms comparing women randomized to low-dose oral conjugated estrogens or transdermal plus micronized progesterone versus placebo: the Kronos Early Estrogen Prevention Study. Menopause 2017;24:238- 46.

Ockene JK, Barad DH, Cochrane BB, Larson JC, Gass M, Manson JE, “et al”. Symptom experience after discontinuing use of estrogen plus progestin. JAMA 2005;294:183-93.

Cann CE. Spinal mineral loss in oophorectomized women. Determination by quantitative computed tomography. JAMA 1980;244:2056-59.

Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, “et al”. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321-33.

Sprague BL, Trentham-Dietz A, Cronin KA. A sustained decline in menopausal hormone use: results from the National Health and Nutrition Examination Survey, 199-2010. Obstet Gynecol 2012;120:595-603.

Rocca WA, Bower JH, Maraganore DM, Ahlskog JE, Grossardt B, De Andrade M, “etal” Increased risk of cognitive impairment or demetia in women who underwent oophorectomy before menopause. Neurology 2007;69:1074–83.

Manson JE, Bassuk SS. Invited Commentary: Hormone therapy and risk of coronary heart disease-why renew the focus on the early years of menopause? Am J Epidemiol 2007;166:511–17.

Mendelsohn ME, Karas RH. HRT and the young at heart. N Engl J Med 2007;356:2639–41.

Siegfried T. Neuroscience: it’s all in the timing. Nature 2007;445:359–61.

Henderson VW, Brinton RD. Menopause and mitochondria: windows into estrogen effects on Alzheimer’s disease risk and therapy. Prog Brain Res 2010;182:77–96.

Harmanli O, Shinnick J, Jones K, St Marie P. Obstetrician-Gynecologists’ Opinions on Elective Bilateral Oophorectomy at the Time of Hysterectomy in the United States. Menopause 2014;21:355–60.

Salpeter SR, Cheng J, Thabane L, Buckley NS, Salpeter EE. Bayesian meta-analysis of hormone therapy and mortality in younger postmenopausal women. Am J Med 2009;122:1016–22.

Allison MA, Manson JE, Aragaki A, Langer RD, Rossouw J, Curb D, “et al” Vasomotor symptoms and coronary artery calcium in postmenopausal women. Menopause 2010;17(6):1136–45

Manson JE, Allison MA, Rossouw JE, Carr JJ, Langer RD, Hsia J, “et al”. WHI and WHI-CACS Investigators. Estrogen therapy and coronary-artery calcification. N Engl J Med 2007;356:2591–2602.

Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, “et al”. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA 2007;297:1465–77.

Rocca WA, Grossardt BR, De Andrade M, Malkasian GD, Melton LJ. Survival patterns after oophorectomy in premenopausal women: A population-based cohort study. Lancet Oncol 2006;7:821-28.

Parker WH, Broder MS, Chang E, Feskanich D, Farquhar C, Liu Z, “et al”. Ovarian Conservation at the Time of Hysterectomy and Long‐Term Health Outcomes in the Nurses’ Health Study. Obstet. Gynecol. 2009;113:1027–37.

Parker WH, Jacoby V, Shoupe D, Rocca W. Effect of Bilateral Oophorectomy on Women’s Long‐Term Health. Women’s Health 2009;5:565–76.

Rivera CM, Grossardt BR, Rhodes DJ, Brown RD, Roger VL, Melton, LJ, “et al”. Increased cardiovascular mortality following early bilateral oophorectomy. Menopause 2009;16:15–23.

Ingelsson E, Lundholm C, Johansson ALV, Altman D. Hysterectomy and risk of cardiovascular disease: A population‐based cohort study. Eur. Heart J 2011; 2:745–50.

Colditz GA, Willett WC, Stampfer MJ, Rosner B, Speizer FE, Hennekens CH. Menopause and the risk of Coronary Heart Disease in Women. N. Engl. J. Med 1987;31(6):1105–10.

Vujovic S, Brincat M, Erel T, Gambacciani M, Lambrinoudaki I, Moen MH, “et al”. EMAS position statement:Managing women with premature ovarian failure. Maturitas 2010;67:91–93.

Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA. Premature menopause or early menopause: long-term health consequences. Maturitas 2010;65:161–66.

Sherwin BB, Phillips SJ. Estrogen and cognitive functioning in surgically menopausal women. Ann N Y Acad Sci 1990;592:474–75.

The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause 2017;24:728-53.

Pinkerton JV, Santen RJ. Managing vasomotor symptoms in women after cancer. Climacteric 2019;22:544-52.

Jacoby VL, Vittinghoff E, Nakagawa S, Jackson R, Richter HE, Chan J, “et al”. Factors associated with undergoing bilateral-oophorectomy at the time of hysterectomy for benign conditions. Obstet Gyecol 2009;113:1259-67.

Richelson LS, Wahner HW, Melton LJ, Riggs BL. Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. NEJM 1984;311:1273-75.

Kardinaal AFM. Morton MS, Bruggemann-Totgans IEM, Van-Beresteijn ECH. Phyto-Oestrogen excretion and rate of bone loss in postmenopausal women. Eur J Clin Nutr 1998;52;850-55.

Cann CE. Spinal mineral loss in oophorectomized women. Determination by quantitative computed tomography. JAMA 1980;244:2056-59.

Manson JE, Kaunitz AM. Menopause management- getting clinical care back to track. NEJM 2106;374:803-06.

Kling JM, MacLaughlin KL, Schnatz PF, Crandall CJ, Skinner LJ, Cynthia A, “et al”. Menopause management knowledge in postgraduate family medicine, internal medicine and Obstetrics and gynaecology residents. Mayo-Clinic Proc 2019;94:242-53.

DOI: https://doi.org/10.7575/aiac.abcmed.v.9n.3p.10


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.

Advances in Bioscience and Clinical Medicine